South Ridge Family Clinic, LLC
NPI 1881930469ActiveOrganization· Family Medicine· Ellisville, MS
Family Medicine in Ellisville, Mississippi, registered in NPPES in December 2012. The authorized official on file is Marlana Hedgepeth, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1881930469 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 31, 2012 |
| Last updated in NPPES | Dec 31, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MS) |
|---|
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